Biomedical Ethics - Position paper topics (help!) :)

It's getting down to crunch time for me. I want to get a really good topic so i can make this paper rock. I'm a philosophy major but ethics/morality is really not my fav. thing to discuss, so i'm looking for good topics, something not to simple not to broad (i'm looking to write about 8 pages). It can be anything related to the field of biomedical ethics, not necessarily something straight forward like abortion or cloning.
I was thinking about something related to determining personhood, since that relates to a lot of medical ethics topics.... However i'm not sure i'm really prepared to tackle that one.

Any suggestions or help would be highly appreciated!!
thanks in advance!

I think a great one to explore is marketing of prescription drugs, especially directly to patients.

Why market a prescription-only drug directly to patients?

It's because pharmaceutical companies know that patients are generally not going to critically evaluate the ads, and they're going to nag their doctors about it until they get a prescription out of them.

Marketing directly to doctors and to medical students has been well-demonstrated to change prescribing habits. Many medical oversight bodies have now limited access of drug reps to doctors and students. Our prescribing decisions should be based on evidence, on risk-benefit decisions, and on cost-effectiveness decisions. So marketing drugs as just any other product subverts the appropriate decision process, and in-so-doing may lead to harm.

I took a bioethics course a while back when I went through my philosophy degree. I did my final paper on Eugenics. The paper was specifically on Transhumanism, or more precisely the ethical dilemmas involved in "post" personhood by means of artificial augmentation with and without regulation. I also juxstaposed that with Nietzsche and his conception of the ubermensche and the Nazi Eugenics programs. Pretty interesting stuff, especially if you are not really interested in the standard bioethical issues.

But Aedes had a real good topic. It classifies (at least in my mind) with the bioethical autonomy in healthcare. On related topics, you could about the right to minimal health care, the "rationing" of health care, etc.

You could also talk about medical confidentiality and medical information. Mark Siegler has a very good article on this. If you have JSTOR, you might want to look him up. In fact, I'll try to look up the article in a little bit.

You could also write about the right to die, animal testing, and even bioterrorism.

I think i would be interested in the standard bioethical issues if i were Jewish living in Hitler's time.

Thats actually a very interesting chapter in bioethics. There is an issue that I remember about Nazi experiments on jewish prisoners in Concentration camps. I dont remember the specifics, but apparently the Nazis had experimented on the prisoners in realtion to atmosphereic tolerances, cold and heat tolerances, etc. Pretty much everything was tested on these people. But there was an issue which was brought up around ten years ago as to whether or not modern medicine should use the advances gained by the Nazi experiments. For example, the Nazi's had needed a way to combat hypothermia or something like that because they needed to find out how to quickly save downed pilots in the cold nordic oceans. Well, they found out how to do it, and at a substantial loss of human life in the process. The issue comes nowadays becuase apparently the method discovered by the Nazi's is far more efficient than what we have now. So do we use a discovery made at the cost of many lives to save potentially many more?

Thats actually a very interesting chapter in bioethics. There is an issue that I remember about Nazi experiments on jewish prisoners in Concentration camps. I dont remember the specifics, but apparently the Nazis had experimented on the prisoners in realtion to atmosphereic tolerances, cold and heat tolerances, etc. Pretty much everything was tested on these people. But there was an issue which was brought up around ten years ago as to whether or not modern medicine should use the advances gained by the Nazi experiments. For example, the Nazi's had needed a way to combat hypothermia or something like that because they needed to find out how to quickly save downed pilots in the cold nordic oceans. Well, they found out how to do it, and at a substantial loss of human life in the process. The issue comes nowadays becuase apparently the method discovered by the Nazi's is far more efficient than what we have now. So do we use a discovery made at the cost of many lives to save potentially many more?

Certailny use the advances made by the Nazi's experiments, (i hope you mean the results and not practices), what i mean is only if it does not cost more human life, (none whatsoever), as it's already done and why not make use of it especially if it helps, (but as I said as long as noone dies), the only issues here are with your own consience. But if you were to use more human life remember do unto others what you would have done to you

Surely there has to be other ways. I do understand why we tested on animals, (although not morally agree with it), in order for the greater good but i would at least make every effort to look for alternatives, it is only by pure chance that you are not in said sacrificed life's shoes so i ask you would you be willing to die for the greater good if there was an alternative, how do you know there is not another way?

I think it would be nice to be asked do you mind being sacrifced for the greater good out of respect, it's not nice to take someone's life in any sense, (murder, sacrifice, manslaughter etc), because you havent got the right only in extreme self-defence. Besides if you take the wrong route, (and are you sure it is the right route), it is highly likely it wil come back and bite you on the a...

There are some very rare circumstances in which the Nazi medical experiments generated information that just never would have been learned otherwise. Like how many seconds it takes to produce full thickness burns in water of 40, 50, 60, 70, 80, 90 degrees C after immersion of a limb. Or the time it takes to die from hypothermia or to acquire frostbite at various temperatures.

The practical medical merits of this information are not zero, but they're also not exactly breakthroughs.

But the other 99% of the Nazis' medical experiments were either garbage pseudoscience or experiments in mass sterilization or euthanasia techniques.

Furthermore, even by the standards of the day they used abysmally poor research design -- taking marasmic, starving people and conducting uncontrolled clinical trials would have almost no applicability beyond the study population. To say nothing of the complete absence of consent or of pain relief. Not that it mattered -- the subjects who survived the experiments were all gassed or shot anyway.

The Nazi doctors were in many cases professed sadists who in addition to their experiments took part in selection for the gas chambers, and were lock-step Nazi idealogues. Their experiments were a vehicle of cruelty and power FAR beyond their scientific design.

There are some very rare circumstances in which the Nazi medical experiments generated information that just never would have been learned otherwise. Like how many seconds it takes to produce full thickness burns in water of 40, 50, 60, 70, 80, 90 degrees C after immersion of a limb. Or the time it takes to die from hypothermia or to acquire frostbite at various temperatures.

The practical medical merits of this information are not zero, but they're also not exactly breakthroughs.

But the other 99% of the Nazis' medical experiments were either garbage pseudoscience or experiments in mass sterilization or euthanasia techniques.

Furthermore, even by the standards of the day they used abysmally poor research design -- taking marasmic, starving people and conducting uncontrolled clinical trials would have almost no applicability beyond the study population. To say nothing of the complete absence of consent or of pain relief. Not that it mattered -- the subjects who survived the experiments were all gassed or shot anyway.

The Nazi doctors were in many cases professed sadists who in addition to their experiments took part in selection for the gas chambers, and were lock-step Nazi idealogues. Their experiments were a vehicle of cruelty and power FAR beyond their scientific design.

It's just aswell that the Nazi's did this experiment, (first line of your first paragraph), as it is not ethical, if anyone was going to do something like that then its just aswell they did it then. The Nazi's were sadists amongst other things and the reason ethics were not an issue for them because they were cruel sadists.

Certailny use the advances made by the Nazi's experiments, (i hope you mean the results and not practices), what i mean is only if it does not cost more human life, (none whatsoever), as it's already done and why not make use of it especially if it helps, (but as I said as long as noone dies), the only issues here are with your own consience. But if you were to use more human life remember do unto others what you would have done to you [IMG]file:///C:/Users/Jerry/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif[/IMG]

Surely there has to be other ways. I do understand why we tested on animals, (although not morally agree with it), in order for the greater good but i would at least make every effort to look for alternatives, it is only by pure chance that you are not in said sacrificed life's shoes so i ask you would you be willing to die for the greater good if there was an alternative, how do you know there is not another way?

I think it would be nice to be asked do you mind being sacrifced for the greater good out of respect, it's not nice to take someone's life in any sense, (murder, sacrifice, manslaughter etc), because you havent got the right only in extreme self-defence.

Aedes wrote:

There are some very rare circumstances in which the Nazi medical experiments generated information that just never would have been learned otherwise. Like how many seconds it takes to produce full thickness burns in water of 40, 50, 60, 70, 80, 90 degrees C after immersion of a limb. Or the time it takes to die from hypothermia or to acquire frostbite at various temperatures.

The practical medical merits of this information are not zero, but they're also not exactly breakthroughs.

But the other 99% of the Nazis' medical experiments were either garbage pseudoscience or experiments in mass sterilization or euthanasia techniques.

Furthermore, even by the standards of the day they used abysmally poor research design -- taking marasmic, starving people and conducting uncontrolled clinical trials would have almost no applicability beyond the study population. To say nothing of the complete absence of consent or of pain relief. Not that it mattered -- the subjects who survived the experiments were all gassed or shot anyway.

The Nazi doctors were in many cases professed sadists who in addition to their experiments took part in selection for the gas chambers, and were lock-step Nazi idealogues. Their experiments were a vehicle of cruelty and power FAR beyond their scientific design.

I found this article trying to find the case study about the hypothermia experiments.

Probably one of the more horrible aspects, at least in terms of the Nazi hypothermia experiments is (like you had mentioned about poor research design) is that the data collected was scientifically unsound. So the human sacrifice, which was apparently more than 300 people, was essentially for nothing. But I think that I would be of the opinion not to use the research gained by these horrible means... even if it meant deriving some greater medical discovery for the data collected. Also, I agree that any "scientific" advancement from Nazi experimentation seems to have always had a degree of sadism in it. Especially considering the nature of some of these scientists, like Dr. Rascher.

If you look at some of the experiments conducted by Josef Mengele on children (especially twins) at Auschwitz-Birkenau, one need not be a scientist to see the needlessness and barbarity of them.

But what is telling is what he (and the other Auschwitz doctors) did when they weren't conducting experiments. They supervised the selections of trainloads of Jews, and therein sent hundreds of thousands of people to either instant death or forced labor and starvation. And Mengele's letters and notes written when he was in exile in Brazil after the war show that he was continually obsessed with the differences between races. This kind of perspective on the subjects of their experiments, mixed with the appalling cruelty with which they were conducted, show that it's not even possible to derive valid science from it. And part of this has to do with the lengths the Nazis took to hide their activities. One cannot trust the scientific documentation of an enterprise that is inseparable from a massive crime that they are trying to hide.

Any clinical trial requires that you ascertain descriptive information about your study population. And in the case of the medical experiments, we're talking about a population of Jews, Roma, political prisoners, prisoners of war, etc who had already been starved for years by the time of the experiments -- but to disclose these baseline subject characteristics would be to risk admission of this crime.

Probably one of the more horrible aspects, at least in terms of the Nazi hypothermia experiments is (like you had mentioned about poor research design) is that the data collected was scientifically unsound. So the human sacrifice, which was apparently more than 300 people, was essentially for nothing. But I think that I would be of the opinion not to use the research gained by these horrible means... even if it meant deriving some greater medical discovery for the data collected. Also, I agree that any "scientific" advancement from Nazi experimentation seems to have always had a degree of sadism in it. Especially considering the nature of some of these scientists, like Dr. Rascher.

How can you be permitting the means when it is already been permitted? I agree the means does not permit the end but we're talking about sadists, not you, sadists whom already did the experiments. Wouldnt you want some good to come oout of it instead of people dying for nothing, are you feeling guilty? I did not realise that there were still survivors who'd just been maimed, I gues I'd feel that was wrong to use there suffering and now I feel it's wrong about the others, it is awful, I think my point was if it'd the research had been already done by the Nazi's who were sadists, im not a sadist and if it meant saving lives you would do it coz i think and feel thath if a dead victim or even an alive maimed person thought if it meant their suffering would save say someone they loved they may agree to somone who had nothing to do with it use that research for the greater good, and you're not actually do anything to them it was the Nazi's, infact not would it save someone's life but would create a whole new world-one maybe they'd benefit it from too if they were still alive. I would by no means encourage any repetition for the research, it was wrong and if it was wrong shouldn't there be another way anyway?

How can you be permitting the means when it is already been permitted?

We still listen to works by Richard Strauss and discuss the philosophy of Martin Heidegger -- both Nazis (and sort of ruthlessly so in Heidegger's case). This is because their contributions are not completely entwined with their methods.

We accept the technological contribution of Wehrner von Braun, despite the fact that he essentially relied on a concentration camp (Nordhausen) where thousands of Jews died. This remains an area of active ethical debate, but mainly because NASA hired von Braun after the war.

But the Nazi doctors... their research was conducted so cruelly, in a way so anathema to medicine and humanitarianism, that to reject it would have symbolic importance. Open and important research questions could be revisited within the bounds of sound design and ethical conduct.

One of my grandmothers was hand-selected into the work line by Josef Mengele when she detrained in Auschwitz in 1944 (after the Lodz ghetto was liquidated). It's been over 60 years, and she still has nightmares about looking in his eyes.

I did say it feels wrong and it feels even more wrong after what you said about your Grandmother Aedes and I think i portrayed this in my very first post How can the Nazi's justify what they did with those children, i dont get it.

Aedes, i really wish i hadn't followed your link, i dont want to know, i know it's awful already i know of this sickening era and i can't bare to read it. My grandad is dead, whilst he served in the army him and a load of others were told to look at a mushroom cloud, he diedaged 65 when i wa sis, i miss him even though i was only six and they took away many of years that i could have been with my grandad who i love, they took him away from me and it...........

Yes i remember the Neuromberg trials, (hearing/reading about them). The guilty for such atrocities should've gone to prison for life and serve life hmmmph! what but what about justice for my Grandad?

not to change the subject... but i've decided to take your suggestion aedes and write about the commmercialization of prescription medication. to my enjoyment there are lots of articles about it out there which equals easy research. yay!

This stuff is hard to read, and the more you know about it -- and particularly if you grow up in a family that survived and witnessed it -- the more horrible you realize it was.

But how can we talk about ethics without having a framework? Modernity has taught us that our (humanity's) capacity for cruelty is worse than our imagination and reason would ever predict.

Does having such an enormous capacity prevent one creating a framework. Even though it is worse than we would ever predict does that actually stop us trying to create a framework that we can make ethics work?

not to change the subject... but i've decided to take your suggestion aedes and write about the commmercialization of prescription medication. to my enjoyment there are lots of articles about it out there which equals easy research. yay!

That's great, I hope it works well for you! There are editorials about this in many of the big medical journals like JAMA (Journal of the American Medical Association), The New England Journal of Medicine, and Annals of Internal Medicine. If you're at a university with a medical school, you probably already have online full-text access to Medline (via PubMed).

Caroline;55460 wrote:

Does having such an enormous capacity prevent one creating a framework. Even though it is worse than we would ever predict does that actually stop us trying to create a framework that we can make ethics work?

It doesn't stop us or prevent us -- it just makes us realize that debates over utilitarianism versus deontology are mere trifles when we can conceptualize a "crime against humanity". Suffering becomes a central concept to modern moral philosophy.